Pancreas Flashcards
(39 cards)
Where is the pancreas located
behind the stomach, surrounded by the duodenum, liver, and spleen
What does the pancreas produce
produces insulin, glucagon, somatostatin and releases it into the vascular system
What does the pancreas secrete
digestive enzymes: lipase, amylase, trypsin and chymotrypsin, bicarbonate
What does lipase do
digest fats
What does amylase do
digest carbs
What does trypsin and chymotrypsin do
digest proteins
When are pancreatic enzymes triggered and released
with food
Pancreatitis
dysfunctional pancreas undergoes inflammation and cellular injury caused by the leakage of digestive enzymes into glandular tissue
Etiology of pancreatitis
biliary tract disease, alcohol abuse, abdominal trauma, hypoperfusion, prescription drugs
How do gallstones cause pancreatitis
they lodge in the common bile duct and obstruct the flow of enzymes from the pancreas –> back-up and perform autodigestion on the gland tissue –> destroy pancreatic cells
What does autodigestion lead to
damaged pancreatic cells, edema, vascular insufficiency, and ischemia of the gland
How does alcohol, drugs, and infectious agents cause damage to the pancreas
the substances reach the pancreas and cause premature activation of pancreatic enzymes
What does ethanol do to the pancreas
increases the permeability of ductules –> enzymes reach the tissue and cause pancreatic damage, increases the protein content of pancreatic juice, decreases bicarbonate levels, and hinder trypsin inhibitor –> acids to injure the gland and protein plugs to block pancreatic outflow
Clinical presentation of pancreatitis
severe abdominal pain, nausea, vomiting, diarrhea, anorexia, fever, tachycardia, hypotension, diminished bowel sounds, jaundiced/pale, cullen sign, grey turner sign
Cullen sign
bluish discoloration around the umbilicus resulting from blood in the peritoneal cavity because of hemorrhagic pancreatitis
Grey turner sign
reddish-brown discoloration along the flanks resulting from retroperitoneal bleeding
Blood work for diagnosis
amylase, lipase, CBC, glucose, BUN, calcium, lactate dehydrogenase
Amylase
early to respond to an injury
Lipase
spikes 24 hours after the onset of symptoms
Lactate dehydrogenase (LDH)
tells us if there is a tissue injury
Noninvasive imaging
abdominal and endoscopic ultrasound, CT, MRCP
What does a MRCP show
the biliary and pancreatic ducts
Treatment of pancreatitis
supportive care, minimize pancreatic stimulation, maintain optimal fluid balance, close monitoring of complications, NPO until abdominal pain and tenderness have subsided and bowel sounds return, NG suctioning for bile or ileus, central line placement for fluid and electrolyte management
Necrotic pancreatitis
death of pancreatic tissue
